Payment Status Check

Process Server Name: *
Today's Date: *
Field Sheet Number (1): *
Field Sheet Number (2): *
Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (3): *
Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (4):
Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (5): *
Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (6): *
Type N/A in this field if you do not have another Field Sheet to enter.
Did you mail the "Original Affidavit" to our office at least (35) days ago? *
There are many cases where the original could have been lost in the mail or we receive incomplete Affidavits (not signed, completed or notarized).

We cannot research payment for jobs that we have not yet received the original Affidavit for because we process payments upon receipt and "approval" of the original Affidavit.

If you did not mail the original Affidavit at least (35) days ago, you should not report the job numbers on this form.
Email Address (for confirmation): *

Type your email address in this field for an automated confirmation and copy of this form.